Snapshot quiz 18/2

Published: 03/16/2018

Authors: Landerholm K and Guy R

The strictures are non-steroidal anti-inflammatory drug-induced. These are sometimes known as diaphragm disease owing to their hour-glass appearance. Enteropathy with multiple distal small bowel strictures is most common, but colopathy with strictures predominantly in the right colon has also been described. This patient took long-term ibuprofen before developing obstructive symptoms25 years ago, but was managed on a low-residue diet until the symptoms became disabling. In addition to multiple ileal strictures and faecoliths, he had a stricture in the proximal ascending colon confirmed by intraoperative endoscopy after removal of the appendix. An extended ileocaecal resection incorporating all strictures was performed with ileocolic anastomosis.